‘No red flags’ before birth of breech baby who died, midwife says
A midwife has said there were ‘no red flags’ the day before a pregnant woman’s undiagnosed breech baby died, an inquiry has heard.
Baby Mirabelle Bosch died when she was just 12 hours old on July 2, 2021 at Wishaw General Hospital, after she suffered a hypoxic brain injury during a home birth.
Mirabelle’s mum, Rozelle Bosch, 31, also faced delays in getting to hospital after the high risk birth.
A fatal accident inquiry into her death will also examine the deaths of two other newborns in NHS Lanarkshire hospitals: Ellie McCormick, who died at the same hospital aged just five hours on March 5 2019; and Leo Lamont, who died at two hours old in University Hospital, Monklands, on February 15 2019.
Medics believed Mirabelle was head-down in a ‘low risk’ pregnancy – but she was actually in breech, which requires a management plan for a hospital birth due to head injury risks for the baby.
A 31-week scan identified Mirabelle was in breech but a midwife gave evidence and said this was not a cause of concern at that time.
First-time mother Mrs Bosch had no concerns throughout her pregnancy and Mirabelle appeared healthy, but when labour began, her feet emerged rather than her head, which became “entrapped”, causing her death, the inquiry heard.
On June 30, midwife Michelle Tannahill examined Mrs Bosch, who had attended Wishaw General after her waters broke, and was then sent home with no formal written guidance from the NHS about active labour.
Ms Tannahill told the inquiry at Glasgow Sheriff Court a vaginal examination could ‘possibly’ have found the baby was in breech but would have been avoided due to the risk of infection.
Ms Tannahill also said there was no reason for her to seek a second opinion as she believed she could feel the baby’s skull.
She said: ‘From my assessment of it, I determined it was a head that I was feeling at the brim and the buttocks at the top. I had no difficulty when I was listening into the heartbeat at all, there was no difficulty picking up the heart.
‘From what I was feeling above the brim of the pelvis, I felt that was the head, normally a bony prominent part rather than soft buttocks.
‘The head was not mobile, that’s how I came to the conclusion it was fixed in the pelvis. Above the brim of the pelvis I could feel four-fifths of the head. The colour of liquid was clear, there was no concerns over the baby’s movements.’
She added: ‘The midwives who work with risk management who carried out an extensive investigation into what happened and they did not see anything wrong with my practice.
‘No, there wasn’t any red flags, everything that I had found that night was within my scope of practice within midwifery. There wasn’t anything that was alarming.’
A statement from the baby’s father, Eckhardt Bosch, had questioned why no vaginal examination was carried out.
Ms Tannahill said: ‘You want to minimise any intervention which is unnecessary due to the risk of infection. There was no reason for me to examine – there was good reason to avoid doing one.’
After she was discharged home, retired midwife Alison Stark spoke to Mrs Bosch on July 1 at 2.29pm, the inquiry heard.
She said: ‘If a woman during the conversation seemed to be in pain or distressed, we would obviously suggest they would come to the unit.
‘You couldn’t really determine if they were in active labour until they were seen, you could only go with what they were telling you on the telephone.’
The inquiry continues.
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